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In 2021, we noted an increase in hospital acquired pressure injuries (HAPI) in our Pediatric Intensive Care Unit (PICU). In 2021 there were 41 HAPIs resulting in a rate of 3.44 HAPIs per 1000 patient days. In our deep dive into the causative factors, we determined there was a marked increase in respiratory device related pressure injuries from 2021-2022 as well as pressure injuries related to turning and repositioning leading us to believe our current prevention measures should be reviewed. To combat this, we formed an interdisciplinary team aimed at reducing HAPIs. Together with our respiratory therapy department we introduced new products such as gel barriers, new masks for non-invasive positive pressure ventilation, a moisture wicking barrier device, a proning system, and a wedge turning system. We also provided education on currently available products and practices. Because so many of our pressure injuries were related to non-invasive ventilation facemasks, we instituted a new practice in which a second mask of a different size was always kept at the bedside. We worked with our hospital wide HAPI committee to update our prevention bundle and created a turning and repositioning guideline for our high-risk patients. To disseminate this information to bedside staff and providers, we held in-services, roadshows for hands on exposure to new products, and presentations in staff meetings. Our Quality Improvement Nurse aided us in tracking and trending our HAPI numbers as well as correlating the implementation of our interventions to our results. As of the end of June 2023, we have reduced our HAPI rate by 69.5% to a rate of 1.05. The use of a multidisciplinary team to assess the current practice as well as implement changes to our HAPI prevention practices has shown promising results in our goal of decreasing HAPIs in the PICU.

Publication Date

2023

We’re Not HAPI and We Know It.

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